Individual provider Active NPI

Maria Isabel Clemente, MD

  • Pediatrics Physician
  • Weston, FL
National Provider Identifier
1972696177
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME87220 Issued in FL
Practice address
1625 N Commerce Pkwy Ste 205
Weston, FL 33326-3206
Phone
(954) 659-8550
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME87220 FL Primary
Exclusive Provider Organization 302F00000X

Addresses

Primary practice location

1625 N Commerce Pkwy Ste 205
Weston, FL 33326-3206

Mailing address

1625 N Commerce Pkwy Ste 205
Weston, FL 33326-3206
Phone (954) 659-8550

Other practice location 1

2476 N University Dr
Pembroke Pines, FL 33024-3624
Phone (954) 436-0068

Other identifiers 1

IdentifierTypeStateIssuer
271831600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME87220FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Peditarics, P.a. Current Accepting new patients
One Source Pediatrics P.a Current Accepting new patients
Pasadena Pediatrics, P.a. Current Accepting new patients

Locations

2476 N University Dr
Pembroke Pines, FL 33024
Phone (954) 436-0068

1625 N Commerce Pkwy
Ste 205
Weston, FL 33326
Phone (954) 389-8691

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1972696177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N COMMERCE PKWY STE 205",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263206",
            "telephone_number": "954-659-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N COMMERCE PKWY STE 205",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263206",
            "telephone_number": "954-659-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2476 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330243624",
            "country_code": "US",
            "telephone_number": "954-436-0068",
            "fax_number": "954-431-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "MARIA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME87220",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271831600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.